Lansley launches CCIO Leaders Network

8 March 2012EHI staff

Health secretary Andrew Lansley

Health secretary Andrew Lansley has launched the EHI CCIO Leaders Network, saying it will help to bridge the gap between the IT that clinicians use in their day to day lives and the IT they have to use in the NHS.

Speaking at the Royal College of Physicians in central London, Lansley said it was “intolerable” that clinicians who regularly use a smarthphone to video chat with their colleagues have to spend weeks waiting for patient information to be sent by post.

But he said the gap had to be closed “by the leadership of those with their patients in mind, not by decree from central government.”

“In the past, doctors and nurses have had to bend over backwards to fit in the needs of the systems introduced in their workplaces.

"They were shacked with rigid, expensive, IT contracts that failed to deliver as intended,” he said.

“We are now putting local clinicians in the driving seat, able to reap the benefits of the explosion in information and technology that is reforming the world beyond the NHS.”

The launch of the EHI CCIO Leaders Network marks the end of the first phase of the EHI CCIO Campaign, which was set up to encourage all NHS providers to appoint a chief clinical information officer to lead on IT projects and the use of information to improve patient care.

The network is being developed in partnership with the RCP and the British Computer Society, with support from BT, Cerner and iSoft, to support the seven CCIOs that have already been appointed, and to help identify and promote more.

The network has dedicated pages on the EHI website, and will hold a series of events over the coming year, looking at everything from the business case for CCIOs, to how they might support standards and better record keeping, to their role in specific sectors, such as mental health.

Jon Hoeksma, the editor of eHealth Insider, said: “The response to the campaign has been terrific and the momentum it has generated will get the CCIO Leaders Network off to a flying start.

“We have nine further events planned for 2012, and an online channel that will be offering news, information and peer support to clinicians taking on these vital roles.”

At the launch event, Lansley aligned the network with the government’s broader direction on IT, which he said was to avoid top-down initiatives and give control to trusts and those working in them.

He confirmed that the government is determined to dismantle the remains of the National Programme for IT in the NHS, and that NHS Connecting for Health, the agency that runs it, will cease to exist after April 2013.

He said CfH will be replaced by a “leaner” delivery organisation to run N3 and national applications and services.

Lansley confirmed that the government has secured “over a billion pounds” reduction in its contract with CSC for the North, Midlands and East of England, and £1.8 billion from the programme's contracts as a whole.

He indicated that this money will be “released back to the NHS” - although he said no exact figures would be available until the deal with CSC is finally signed.

Lansley said that in future it would be essential for “clinical systems across the country to talk to each other” and to “exchange information safely in the interests of patients.”

"We are delighted to continue our support with this exciting evolution of the campaign.”

Alan Fowles, vice president and general manager Cerner UK and Ireland, said during the launch: “Cerner has proudly supported the CCIO campaign from the outset and it is exciting to see that support has gone from strength to strength.

“The most significant improvements are brought about when healthcare technology is closely aligned to medical practice.

"As a foundation sponsor of the CCIO Leaders Network, we look forward to the campaign pairing strong clinical leaders and innovative IT in the NHS in future."

Adrian Stevens, iSOFT's managing director for UK and Ireland, Middle East and Africa, agreed, saying: “It is vital to involve clinicians at every step, from initial specification through procurement to delivery.

"We know from own experience the importance of involving our clinicians in product development and the readiness of our customers to embrace clinically rich developments.”

One or two of the other reasons that GP computing has been successful (and as yet unmentioned) is the fact that for a significant number of years the systems have been subsidised and broadly standardised by CfH and it's predecessors. Also successive governments have paid GP's to use or incentivised payments which result in improved usage.

There hasn't really been the same focus on Acute/Community until NPfIT came along and instead of following the successful GP model chose dictatorship instead.

I believe it's the way patient information is presented, a simple summary highlighting key patient facts and current problems and then a simple journal of clinical events (early facebook?). [Surely this alone reduce the reliance on admin staff retrieving clinical records]

On top of this and equally important is the way clinical information was recorded from the offset, read codes in a very small number of tables. This made searches and reports easy to build and probably more powerful.

Make the 'small' step into community and your presented with masses of tables, little information reuse, requiring more expensive IT staff.

Kevin, you are right here, and it is an important point. The Read Codes allowed the development of generic "clinical statements" which allowed a wide variety of apparently heterogeneous findings, procedures and notes to be recorded using a common format, and more importantly, to be reported together, for example in strict accession order.

One of the biggest reasons (there are several) why GP computing was successful was that the suppliers commoditised it from the outset. They could see that GPs would never pay for personalised bespoke systems so they said "any colour you like as long as its black". Compare this with lab systems, where every lab has developed its own bespoke coding scheme.

Like much else about Mr Lansley, his view of NHS IT seems more than a little naive. So big, rigid contracts failed to deliver? Fair point. Letting a thousand flowers bloom, also failed to deliver, but we seem to be looking again to Percy Thrower for our IT strategy (Monty Don for you youngsters).

It is all well and good expecting CCIOs to lead local projects which prioritise improvements in patient care, and expecting the standard setting function of the Commissioning magically make it all join up, but you'll forgive me for not holding my breath on that one.

It is not that I think CCIOs are a bad idea - clearly that's not that case - but there is a danger that we go back to the days of a patchwork of uncoordinated pet projects driven by narrowly focused enthusiasts, whether they're clinical or management led.

The reason that GP IT has been so successful (apart from an inherent entrepreneurial streak in many GPs) is that the business of general practice is far, far simpler than acute services and it's dominated by a single clinical profession with a broad outlook and who are often fully involved in management decisions. The acute sector is the diametric opposite of that, so it's going to take some exceptional CCIOs to rise above their narrow professional interests and see the bigger picture, whilst negotiating the internal politics of their Trust.

One could argue that the Acute sector has always struggled to really take advantage of what IT could deliver and as a consequence has all to often applied IT to a largely unmodified administrative system. Yes the (rather late) adoption of Order Comms and rules based system are starting to make a change, but the hugely larger size, environment and complex clinical organisations are also factors.

Yhis is exactly where the CCIO can make a difference. Working form a position of clinical leadership anbd respect to introduce the cultural and operational change associated with making IT an improvement for patient/clinical practice and operational efficiency.

GP IT systems are not only successful, they are mission-critical in a way that does not - yet - apply to IT clinical systems anywhere else in the NHS.

And yet when electronic medical records and communication between different care providers are discussed, it is the RCP and not the RCGP which is involved. (there is no reason why both should not be at the top table).

Seeing AL's Bill is likely to be forced through before 1.4.13, should your campaign include every CCG having a CCIO?

When the EHI CCIO Campaign was launched, the structure of clinical-commissioning was very much in doubt. We could hardly have campaigned for CCGs to have CCIOs before CCGs existed. Therefore, the first phase of the campaign focused on the acute sector.

But we've always said the CCIO-idea is one that should be explored in commissioning and primary care as well (just as we've always been clear that this is a role that might be taken on by many people with a clinical background, and not just doctors).

As you can see, the issue was a live one yesterday - but in some ways it's a tribute to the success of the campaign that so many people are keen to see CCIOs in their area. There is an issue about what CCIOs might do in the commisisoning and primary care space. We have commissioned a couple of features on this topic. Watch the new network pages for more...